|
SCREW CANCELLOUS 4.0MMX20MM PARTIAL THRE
|
Facility
IP
|
$35.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
8046900
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$24.50 |
| Max. Negotiated Rate |
$31.50 |
| Rate for Payer: Aetna of IA Commercial |
$31.50
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$31.50
|
| Rate for Payer: Cash Price |
$28.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$26.25
|
| Rate for Payer: Medical Associates Commercial |
$26.25
|
| Rate for Payer: Midlands Choice Commercial |
$24.50
|
| Rate for Payer: United Healthcare Commercial |
$31.50
|
|
|
SCREW CANCELLOUS 4.0MMX20MM PARTIAL THRE
|
Facility
OP
|
$35.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
8046900
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$17.49 |
| Max. Negotiated Rate |
$31.50 |
| Rate for Payer: Aetna of IA Commercial |
$31.50
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$31.50
|
| Rate for Payer: Aetna of IA Medicare |
$19.95
|
| Rate for Payer: Amerigroup Medicaid |
$17.66
|
| Rate for Payer: Amerigroup Medicare |
$17.68
|
| Rate for Payer: Cash Price |
$28.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$26.25
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$17.50
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$17.49
|
| Rate for Payer: Medical Associates Commercial |
$26.25
|
| Rate for Payer: Medical Associates Managed Medicare |
$17.50
|
| Rate for Payer: Midlands Choice Commercial |
$24.50
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$17.76
|
| Rate for Payer: Partners Health Alliance Commercial |
$26.25
|
| Rate for Payer: United Healthcare Commercial |
$31.50
|
| Rate for Payer: United Healthcare Managed Medicare |
$20.65
|
|
|
SCREW CANCELLOUS 4.0MMX22MM BONE FULLY T
|
Facility
OP
|
$35.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
8046974
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$17.49 |
| Max. Negotiated Rate |
$31.50 |
| Rate for Payer: Aetna of IA Commercial |
$31.50
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$31.50
|
| Rate for Payer: Aetna of IA Medicare |
$19.95
|
| Rate for Payer: Amerigroup Medicaid |
$17.66
|
| Rate for Payer: Amerigroup Medicare |
$17.68
|
| Rate for Payer: Cash Price |
$28.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$26.25
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$17.50
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$17.49
|
| Rate for Payer: Medical Associates Commercial |
$26.25
|
| Rate for Payer: Medical Associates Managed Medicare |
$17.50
|
| Rate for Payer: Midlands Choice Commercial |
$24.50
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$17.76
|
| Rate for Payer: Partners Health Alliance Commercial |
$26.25
|
| Rate for Payer: United Healthcare Commercial |
$31.50
|
| Rate for Payer: United Healthcare Managed Medicare |
$20.65
|
|
|
SCREW CANCELLOUS 4.0MMX22MM BONE FULLY T
|
Facility
IP
|
$35.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
8046974
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$24.50 |
| Max. Negotiated Rate |
$31.50 |
| Rate for Payer: Aetna of IA Commercial |
$31.50
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$31.50
|
| Rate for Payer: Cash Price |
$28.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$26.25
|
| Rate for Payer: Medical Associates Commercial |
$26.25
|
| Rate for Payer: Midlands Choice Commercial |
$24.50
|
| Rate for Payer: United Healthcare Commercial |
$31.50
|
|
|
SCREW CANCELLOUS 4.0MMX22MM PARTIAL THRE
|
Facility
OP
|
$35.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
8047003
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$17.49 |
| Max. Negotiated Rate |
$31.50 |
| Rate for Payer: Aetna of IA Commercial |
$31.50
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$31.50
|
| Rate for Payer: Aetna of IA Medicare |
$19.95
|
| Rate for Payer: Amerigroup Medicaid |
$17.66
|
| Rate for Payer: Amerigroup Medicare |
$17.68
|
| Rate for Payer: Cash Price |
$28.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$26.25
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$17.50
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$17.49
|
| Rate for Payer: Medical Associates Commercial |
$26.25
|
| Rate for Payer: Medical Associates Managed Medicare |
$17.50
|
| Rate for Payer: Midlands Choice Commercial |
$24.50
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$17.76
|
| Rate for Payer: Partners Health Alliance Commercial |
$26.25
|
| Rate for Payer: United Healthcare Commercial |
$31.50
|
| Rate for Payer: United Healthcare Managed Medicare |
$20.65
|
|
|
SCREW CANCELLOUS 4.0MMX22MM PARTIAL THRE
|
Facility
IP
|
$35.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
8047003
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$24.50 |
| Max. Negotiated Rate |
$31.50 |
| Rate for Payer: Aetna of IA Commercial |
$31.50
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$31.50
|
| Rate for Payer: Cash Price |
$28.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$26.25
|
| Rate for Payer: Medical Associates Commercial |
$26.25
|
| Rate for Payer: Midlands Choice Commercial |
$24.50
|
| Rate for Payer: United Healthcare Commercial |
$31.50
|
|
|
SCREW CANCELLOUS 4.0MMX24MM BONE FULLY T
|
Facility
OP
|
$35.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
8046727
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$17.49 |
| Max. Negotiated Rate |
$31.50 |
| Rate for Payer: Aetna of IA Commercial |
$31.50
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$31.50
|
| Rate for Payer: Aetna of IA Medicare |
$19.95
|
| Rate for Payer: Amerigroup Medicaid |
$17.66
|
| Rate for Payer: Amerigroup Medicare |
$17.68
|
| Rate for Payer: Cash Price |
$28.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$26.25
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$17.50
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$17.49
|
| Rate for Payer: Medical Associates Commercial |
$26.25
|
| Rate for Payer: Medical Associates Managed Medicare |
$17.50
|
| Rate for Payer: Midlands Choice Commercial |
$24.50
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$17.76
|
| Rate for Payer: Partners Health Alliance Commercial |
$26.25
|
| Rate for Payer: United Healthcare Commercial |
$31.50
|
| Rate for Payer: United Healthcare Managed Medicare |
$20.65
|
|
|
SCREW CANCELLOUS 4.0MMX24MM BONE FULLY T
|
Facility
IP
|
$35.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
8046727
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$24.50 |
| Max. Negotiated Rate |
$31.50 |
| Rate for Payer: Aetna of IA Commercial |
$31.50
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$31.50
|
| Rate for Payer: Cash Price |
$28.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$26.25
|
| Rate for Payer: Medical Associates Commercial |
$26.25
|
| Rate for Payer: Midlands Choice Commercial |
$24.50
|
| Rate for Payer: United Healthcare Commercial |
$31.50
|
|
|
SCREW CANCELLOUS 4.0MMX24MM PARTIAL THRE
|
Facility
IP
|
$35.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
8046373
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$24.50 |
| Max. Negotiated Rate |
$31.50 |
| Rate for Payer: Aetna of IA Commercial |
$31.50
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$31.50
|
| Rate for Payer: Cash Price |
$28.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$26.25
|
| Rate for Payer: Medical Associates Commercial |
$26.25
|
| Rate for Payer: Midlands Choice Commercial |
$24.50
|
| Rate for Payer: United Healthcare Commercial |
$31.50
|
|
|
SCREW CANCELLOUS 4.0MMX24MM PARTIAL THRE
|
Facility
OP
|
$35.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
8046373
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$17.49 |
| Max. Negotiated Rate |
$31.50 |
| Rate for Payer: Aetna of IA Commercial |
$31.50
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$31.50
|
| Rate for Payer: Aetna of IA Medicare |
$19.95
|
| Rate for Payer: Amerigroup Medicaid |
$17.66
|
| Rate for Payer: Amerigroup Medicare |
$17.68
|
| Rate for Payer: Cash Price |
$28.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$26.25
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$17.50
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$17.49
|
| Rate for Payer: Medical Associates Commercial |
$26.25
|
| Rate for Payer: Medical Associates Managed Medicare |
$17.50
|
| Rate for Payer: Midlands Choice Commercial |
$24.50
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$17.76
|
| Rate for Payer: Partners Health Alliance Commercial |
$26.25
|
| Rate for Payer: United Healthcare Commercial |
$31.50
|
| Rate for Payer: United Healthcare Managed Medicare |
$20.65
|
|
|
SCREW CANCELLOUS 4.0MMX26MM BONE FULLY T
|
Facility
IP
|
$35.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
8046728
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$24.50 |
| Max. Negotiated Rate |
$31.50 |
| Rate for Payer: Aetna of IA Commercial |
$31.50
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$31.50
|
| Rate for Payer: Cash Price |
$28.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$26.25
|
| Rate for Payer: Medical Associates Commercial |
$26.25
|
| Rate for Payer: Midlands Choice Commercial |
$24.50
|
| Rate for Payer: United Healthcare Commercial |
$31.50
|
|
|
SCREW CANCELLOUS 4.0MMX26MM BONE FULLY T
|
Facility
OP
|
$35.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
8046728
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$17.49 |
| Max. Negotiated Rate |
$31.50 |
| Rate for Payer: Aetna of IA Commercial |
$31.50
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$31.50
|
| Rate for Payer: Aetna of IA Medicare |
$19.95
|
| Rate for Payer: Amerigroup Medicaid |
$17.66
|
| Rate for Payer: Amerigroup Medicare |
$17.68
|
| Rate for Payer: Cash Price |
$28.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$26.25
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$17.50
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$17.49
|
| Rate for Payer: Medical Associates Commercial |
$26.25
|
| Rate for Payer: Medical Associates Managed Medicare |
$17.50
|
| Rate for Payer: Midlands Choice Commercial |
$24.50
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$17.76
|
| Rate for Payer: Partners Health Alliance Commercial |
$26.25
|
| Rate for Payer: United Healthcare Commercial |
$31.50
|
| Rate for Payer: United Healthcare Managed Medicare |
$20.65
|
|
|
SCREW CANCELLOUS 4.0MMX26MM PARTIAL THRE
|
Facility
OP
|
$35.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
8046729
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$17.49 |
| Max. Negotiated Rate |
$31.50 |
| Rate for Payer: Aetna of IA Commercial |
$31.50
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$31.50
|
| Rate for Payer: Aetna of IA Medicare |
$19.95
|
| Rate for Payer: Amerigroup Medicaid |
$17.66
|
| Rate for Payer: Amerigroup Medicare |
$17.68
|
| Rate for Payer: Cash Price |
$28.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$26.25
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$17.50
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$17.49
|
| Rate for Payer: Medical Associates Commercial |
$26.25
|
| Rate for Payer: Medical Associates Managed Medicare |
$17.50
|
| Rate for Payer: Midlands Choice Commercial |
$24.50
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$17.76
|
| Rate for Payer: Partners Health Alliance Commercial |
$26.25
|
| Rate for Payer: United Healthcare Commercial |
$31.50
|
| Rate for Payer: United Healthcare Managed Medicare |
$20.65
|
|
|
SCREW CANCELLOUS 4.0MMX26MM PARTIAL THRE
|
Facility
IP
|
$35.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
8046729
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$24.50 |
| Max. Negotiated Rate |
$31.50 |
| Rate for Payer: Aetna of IA Commercial |
$31.50
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$31.50
|
| Rate for Payer: Cash Price |
$28.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$26.25
|
| Rate for Payer: Medical Associates Commercial |
$26.25
|
| Rate for Payer: Midlands Choice Commercial |
$24.50
|
| Rate for Payer: United Healthcare Commercial |
$31.50
|
|
|
SCREW CANCELLOUS 4.0MMX28MM BONE FULLY T
|
Facility
OP
|
$35.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
8046995
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$17.49 |
| Max. Negotiated Rate |
$31.50 |
| Rate for Payer: Aetna of IA Commercial |
$31.50
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$31.50
|
| Rate for Payer: Aetna of IA Medicare |
$19.95
|
| Rate for Payer: Amerigroup Medicaid |
$17.66
|
| Rate for Payer: Amerigroup Medicare |
$17.68
|
| Rate for Payer: Cash Price |
$28.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$26.25
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$17.50
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$17.49
|
| Rate for Payer: Medical Associates Commercial |
$26.25
|
| Rate for Payer: Medical Associates Managed Medicare |
$17.50
|
| Rate for Payer: Midlands Choice Commercial |
$24.50
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$17.76
|
| Rate for Payer: Partners Health Alliance Commercial |
$26.25
|
| Rate for Payer: United Healthcare Commercial |
$31.50
|
| Rate for Payer: United Healthcare Managed Medicare |
$20.65
|
|
|
SCREW CANCELLOUS 4.0MMX28MM BONE FULLY T
|
Facility
IP
|
$35.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
8046995
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$24.50 |
| Max. Negotiated Rate |
$31.50 |
| Rate for Payer: Aetna of IA Commercial |
$31.50
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$31.50
|
| Rate for Payer: Cash Price |
$28.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$26.25
|
| Rate for Payer: Medical Associates Commercial |
$26.25
|
| Rate for Payer: Midlands Choice Commercial |
$24.50
|
| Rate for Payer: United Healthcare Commercial |
$31.50
|
|
|
SCREW CANCELLOUS 4.0MMX28MM PARTIAL THRE
|
Facility
OP
|
$35.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
8046985
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$17.49 |
| Max. Negotiated Rate |
$31.50 |
| Rate for Payer: Aetna of IA Commercial |
$31.50
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$31.50
|
| Rate for Payer: Aetna of IA Medicare |
$19.95
|
| Rate for Payer: Amerigroup Medicaid |
$17.66
|
| Rate for Payer: Amerigroup Medicare |
$17.68
|
| Rate for Payer: Cash Price |
$28.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$26.25
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$17.50
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$17.49
|
| Rate for Payer: Medical Associates Commercial |
$26.25
|
| Rate for Payer: Medical Associates Managed Medicare |
$17.50
|
| Rate for Payer: Midlands Choice Commercial |
$24.50
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$17.76
|
| Rate for Payer: Partners Health Alliance Commercial |
$26.25
|
| Rate for Payer: United Healthcare Commercial |
$31.50
|
| Rate for Payer: United Healthcare Managed Medicare |
$20.65
|
|
|
SCREW CANCELLOUS 4.0MMX28MM PARTIAL THRE
|
Facility
IP
|
$35.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
8046985
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$24.50 |
| Max. Negotiated Rate |
$31.50 |
| Rate for Payer: Aetna of IA Commercial |
$31.50
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$31.50
|
| Rate for Payer: Cash Price |
$28.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$26.25
|
| Rate for Payer: Medical Associates Commercial |
$26.25
|
| Rate for Payer: Midlands Choice Commercial |
$24.50
|
| Rate for Payer: United Healthcare Commercial |
$31.50
|
|
|
SCREW CANCELLOUS 4.0MMX30MM PARTIAL THRE
|
Facility
IP
|
$35.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
8046889
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$24.50 |
| Max. Negotiated Rate |
$31.50 |
| Rate for Payer: Aetna of IA Commercial |
$31.50
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$31.50
|
| Rate for Payer: Cash Price |
$28.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$26.25
|
| Rate for Payer: Medical Associates Commercial |
$26.25
|
| Rate for Payer: Midlands Choice Commercial |
$24.50
|
| Rate for Payer: United Healthcare Commercial |
$31.50
|
|
|
SCREW CANCELLOUS 4.0MMX30MM PARTIAL THRE
|
Facility
OP
|
$35.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
8046889
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$17.49 |
| Max. Negotiated Rate |
$31.50 |
| Rate for Payer: Aetna of IA Commercial |
$31.50
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$31.50
|
| Rate for Payer: Aetna of IA Medicare |
$19.95
|
| Rate for Payer: Amerigroup Medicaid |
$17.66
|
| Rate for Payer: Amerigroup Medicare |
$17.68
|
| Rate for Payer: Cash Price |
$28.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$26.25
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$17.50
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$17.49
|
| Rate for Payer: Medical Associates Commercial |
$26.25
|
| Rate for Payer: Medical Associates Managed Medicare |
$17.50
|
| Rate for Payer: Midlands Choice Commercial |
$24.50
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$17.76
|
| Rate for Payer: Partners Health Alliance Commercial |
$26.25
|
| Rate for Payer: United Healthcare Commercial |
$31.50
|
| Rate for Payer: United Healthcare Managed Medicare |
$20.65
|
|
|
SCREW CANCELLOUS 4.0MMX32MM BONE FULLY T
|
Facility
OP
|
$35.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
8046786
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$17.49 |
| Max. Negotiated Rate |
$31.50 |
| Rate for Payer: Aetna of IA Commercial |
$31.50
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$31.50
|
| Rate for Payer: Aetna of IA Medicare |
$19.95
|
| Rate for Payer: Amerigroup Medicaid |
$17.66
|
| Rate for Payer: Amerigroup Medicare |
$17.68
|
| Rate for Payer: Cash Price |
$28.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$26.25
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$17.50
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$17.49
|
| Rate for Payer: Medical Associates Commercial |
$26.25
|
| Rate for Payer: Medical Associates Managed Medicare |
$17.50
|
| Rate for Payer: Midlands Choice Commercial |
$24.50
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$17.76
|
| Rate for Payer: Partners Health Alliance Commercial |
$26.25
|
| Rate for Payer: United Healthcare Commercial |
$31.50
|
| Rate for Payer: United Healthcare Managed Medicare |
$20.65
|
|
|
SCREW CANCELLOUS 4.0MMX32MM BONE FULLY T
|
Facility
IP
|
$35.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
8046786
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$24.50 |
| Max. Negotiated Rate |
$31.50 |
| Rate for Payer: Aetna of IA Commercial |
$31.50
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$31.50
|
| Rate for Payer: Cash Price |
$28.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$26.25
|
| Rate for Payer: Medical Associates Commercial |
$26.25
|
| Rate for Payer: Midlands Choice Commercial |
$24.50
|
| Rate for Payer: United Healthcare Commercial |
$31.50
|
|
|
SCREW CANCELLOUS 4.0MMX35MM PARTIAL THRE
|
Facility
OP
|
$35.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
8046702
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$17.49 |
| Max. Negotiated Rate |
$31.50 |
| Rate for Payer: Aetna of IA Commercial |
$31.50
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$31.50
|
| Rate for Payer: Aetna of IA Medicare |
$19.95
|
| Rate for Payer: Amerigroup Medicaid |
$17.66
|
| Rate for Payer: Amerigroup Medicare |
$17.68
|
| Rate for Payer: Cash Price |
$28.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$26.25
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$17.50
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$17.49
|
| Rate for Payer: Medical Associates Commercial |
$26.25
|
| Rate for Payer: Medical Associates Managed Medicare |
$17.50
|
| Rate for Payer: Midlands Choice Commercial |
$24.50
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$17.76
|
| Rate for Payer: Partners Health Alliance Commercial |
$26.25
|
| Rate for Payer: United Healthcare Commercial |
$31.50
|
| Rate for Payer: United Healthcare Managed Medicare |
$20.65
|
|
|
SCREW CANCELLOUS 4.0MMX35MM PARTIAL THRE
|
Facility
IP
|
$35.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
8046702
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$24.50 |
| Max. Negotiated Rate |
$31.50 |
| Rate for Payer: Aetna of IA Commercial |
$31.50
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$31.50
|
| Rate for Payer: Cash Price |
$28.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$26.25
|
| Rate for Payer: Medical Associates Commercial |
$26.25
|
| Rate for Payer: Midlands Choice Commercial |
$24.50
|
| Rate for Payer: United Healthcare Commercial |
$31.50
|
|
|
SCREW CANCELLOUS 4.0MMX36MM BONE FULLY T
|
Facility
IP
|
$35.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
8047031
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$24.50 |
| Max. Negotiated Rate |
$31.50 |
| Rate for Payer: Aetna of IA Commercial |
$31.50
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$31.50
|
| Rate for Payer: Cash Price |
$28.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$26.25
|
| Rate for Payer: Medical Associates Commercial |
$26.25
|
| Rate for Payer: Midlands Choice Commercial |
$24.50
|
| Rate for Payer: United Healthcare Commercial |
$31.50
|
|
